Abstract Background: Older adults with hearing loss are at increased risk of cognitive impairment, yet tailored risk stratification tools remain limited. Methods: In this cross-sectional study, 524 adults aged ≥60 years with hearing loss were enrolled between June 2023 and September 2024. Participants were divided by enrollment period into a development cohort (June 2023 to May 2024, n = 367) and a temporally independent validation cohort (June 2024 to September 2024, n = 157).